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There is currently a lack of guidelines with regard to tubercular uveitis (TBU) management in Taiwan. We therefore propose an evidence-based consensus on the management for TBU. The Taiwan Ocular Inflammation Society conducted a meeting that included nine ophthalmologist and one infection disease expert that focused on three broad areas of (1) nomenclature for TBU, (2) assessment and diagnosis for TBU, and (3) treatment of TBU. Brief literature review on TBU diagnosis and management was conducted that informed this panel meeting in order to make decisions on each consensus statements. In terms of our results, a consensus statements and recommendations for the diagnosis and management of TBU were developed. This consensus statement provides an algorithmic approach toward diagnosing and managing TBU. These statements are meant to enhance but not replace individual clinician–patient interactions and to facilitate real-world clinical practice improvement in terms of TBU patients care. [ABSTRACT FROM AUTHOR]

Introduction: This study investigated the prevalence and perception of premorbid lifestyle-related risk factors among Covid-19 Survivors in Abuja and Lagos, Nigeria. Methodology: A cross-sectional descriptive survey design was used to collect data from 522 consenting adult Covid-19 survivors in Abuja (274) and Lagos (248), Nigeria, using a self-developed, close-ended and validated questionnaire called the Lifestyle-related Factors in Covid-19 Questionnaire (LFC-19 Questionnaire) through a multistage sampling technique. Descriptive and inferential statistical analysis was done using the Statistical Package for Social Science (SPSS) with P value set at ≤ 0.05. Ethical approval was obtained for the study. Results: A significant number of Covid-19 Survivors were overweight/obese (67.8%) and had a history of physical inactivity (73.8%). A small proportion had premorbid chronic diseases (23.8%) as well as pre-existing lifestyle-related risk factors such as inadequate consumption of fruits (67.2%) and vegetables (60.0%) and physical inactivity (73.8%). Conclusion: This study revealed that most Covid-19 survivors residing in Lagos State and in Abuja capital city of Nigeria were either overweight or obese. This was due to physical inactivity, an unhealthy diet consisting of low fruit and vegetable consumption and poor sleep. Additionally, the study showed that patients' perceptions of their risk factors were often inaccurate as it differed from what was measured. The findings from this study will assist public health professionals and clinicians in designing and implementing more effective Covid-19 management strategies that incorporate healthy lifestyle practices and lifestyle modifications and assist public health promotion and communication specialists in designing appropriate and evidence-based preventive messages. [ABSTRACT FROM AUTHOR]

Objective: To search for and summarize the best evidence for themanagement of elderly patients with dysphagia. Methods: Clinical decisions, recommended practices, evidence summaries, clinical practice guidelines, expert consensus, and systematic reviews on the management of dysphagia among elderly patients were systematically reviewed from domestic and foreign guideline websites, association websites, and Chinese and English databases according to the 6S model of evidence-based resources. The search period was between January 1, 2010 and November 1, 2023. Two researchers evaluated the quality of the included literature respectively and extracted evidence. Results: A total of 14 literatures were identified, including 2 guidelines, 2 clinical decisions, 5 evidence summaries, 3 expert consensus statements, and 2 systematic reviews. Twenty-four pieces of evidence from 7 aspects were summarized, including assessment, treatment and rehabilitation, medication care, nutrition management, oral care, complication management, and psychological care. Conclusion: The best evidence-based recommendations for the management of dysphagia in elderly patients is summarized, it is suggested that the best evidence should be selected according to the actual situation of patients, and a personalized management plan should be formulated to improve the quality of life of patients and achieve high-quality nursing. [ABSTRACT FROM AUTHOR]

Aim: To understand the current usage of eviQ Cancer Treatments Online (www.eviQ.org.au), an Australian, open‐access website providing evidence‐based and consensus‐driven cancer treatment protocols and information, and the extent to which it is meeting its intended outcomes and providing value to its users. Methods: A mixed‐method evaluation was conducted in 2020−2022 which included a review of key program documentation and website usage data, and delivery of a focused online survey to its users. Results: In 2022, 329 clinicians representing all Australian states and territories contributed to eviQ content development and review. eviQ content continues to grow with a 15.2% increase in total content from 2019 to 2022. eviQ website users continue to grow with 90,000 total monthly users in 2022, representing a 166% increase from 2018. The proportion of international users compared to Australian users continues to grow with 57% of total users in Australia and 43% international in 2022. Of 466 survey responses, the most cited reason for eviQ use was for information on side effects/toxicity (67%). Ninety‐three percent (93%) of respondents either agreed or strongly agreed that eviQ contributed to both health professionals providing the best evidence‐based treatment and care and improving the standardization of treatment and care provided. Conclusion: eviQ is embedded in Australian clinical practice, highly valued, and relied upon by users. Users agree that eviQ has a positive impact on patients by supporting the delivery of evidence‐based treatment and that eviQ contributed to patients' improved health outcomes and quality of life. eviQ's increasing international usage should be explored. [ABSTRACT FROM AUTHOR]

With the increased complexity of healthcare systems, an increased need for healthcare managers to effectively deliver and manage health services escalates. The research findings acknowledge Evidence-Based Management (EBMgt) as the best management practice available. This study aims to explore the intentions of hospital managers to use EBMgt practice in Jordan, by using the Theory of Planned Behavior (TPB) to predict the intentions of hospital managers. A quantitative, cross-sectional study has been performed among 232 managers in 29 hospitals in the northern and middle parts of Jordan. A self-administered survey has been distributed to the participants. The data were analyzed using structural equation modeling. The three constructs of the TPB (attitude, subjective norm, and perceived behavioral control) all had a significant positive impact on hospital managers' intention to use EBMgt. Subjective norm was the strongest predictor among the three constructs. Hospital managers had a positive attitude toward the adoption of EBMgt concept in their decision-making process. Several factors could influence the adoption of this practice among hospital managers; including organizational culture, and familiarity with the concept. Further investigation is needed to clarify those factors in the healthcare management sector in Jordan. [ABSTRACT FROM AUTHOR]

With the increasing interest and investment in research and development (R&D), the need for more efficient research project management has grown. Accordingly, we built prediction models to classify research projects that were expected to show excellent research output. Specifically, we applied five machine learning techniques to build prediction models. In an empirical analysis of data on research projects funded by South Korea over the last five years (2014–2018), we found that the automated machine learning model (autoML), in which the machine builds the most suitable learning model, shows relatively greater and more robust performance than models based on other techniques. We also established that research funding and project type played the most important roles in predicting excellent research projects. This study is significant because it shows the need for a paradigm shift in building an evidence-based project management system by verifying the utility and applicability of a data-driven approach in R&D project management. [ABSTRACT FROM AUTHOR]

Simple Summary: Our aims were to investigate whether the Farm Animal Welfare Committee 2011 target of prevalence of lameness in English sheep flocks of <2% by 2021 had been achieved and to identify management practices associated with controlling lameness. A retrospective postal survey was sent to a random sample of 1000 English farmers. The usable response percentage was 26.9%. The geometric mean prevalence of lameness was <2% in ewes and lambs, but the median was 3%; approximately 26% flocks had <2% lameness. Farmers that quarantined ewes for 3 or more weeks and did not use footbathing or foot trimming to prevent lameness had a 40–50% lower prevalence of lameness than those not using these practices. More farmers were not using routine foot trimming than in 2018, which is a positive impact. However, more farmers were footbathing sheep, and fewer farmers were using injectable antibiotics to treat footrot, a bacterial disease, which requires antibiotic injection for recovery and to minimise spread of disease. We conclude that the target of <2% lameness in England has been achieved by 26% of farmers, and further work is required for more farmers to follow the evidence-based management practices to minimise lameness. Since 2004, the prevalence of lameness in sheep flocks in England has reduced as farmers have adopted evidence-based management practices to control lameness. In 2011, the Farm Animal Welfare Council proposed a target prevalence of <2% lameness in sheep by 2021. This study investigated whether that target had been achieved and determined which practices were associated with prevalence of lameness. A postal questionnaire was sent to 1000 randomly selected farmers to investigate the prevalence of lameness and management practices in 2022. The geometric mean prevalence of lameness was <2% in ewes and lambs, but the median was 3%; approximately 26% flocks had <2% lameness. Data were analysed using robust variable selection with multivariable linear models. Farmers that quarantined ewes for ≥3 weeks and did not use foot bathing or foot trimming to prevent lameness had 40–50% lower prevalence of lameness than those not using these practices. Fewer farmers (19.0%) were always using parenteral antimicrobials to treat footrot, an effective practice, than in previous research (49.7%). We conclude that the target of <2% lameness in England has been achieved by 26% of farmers, and further work is required for more farmers to follow the evidence-based management practices to minimise lameness. [ABSTRACT FROM AUTHOR]

Objectives In an era of management hype, where management concepts and techniques quickly become buzzwords within the business community (e.g., chat GPT, Artificial Intelligence, pay transparency or Industry 5.0), the crucial skill of a manager is the ability to think critically about the rationality of all those new shiny management practices. To stimulate this, we present a heuristic decision support framework to assist managers in thinking more critically about management fashions - management practices that are intensively promoted and attract public attention but merely imitate rationality and progress. Material and methods We employ a method of conceptual analysis, drawing from Abrahamson's management fashion theory, self-determination theory, literature on management fads and evidence-based management. Results The proposed decision-making support framework presents a decision tree based on three steps to evaluate management practices' rationality, involving critical thinking about their goals, importance, and efficiency. Conclusions The framework can be used not only to assist managerial decision-making but also to teach management students to think more critically and to empower the business community to question the rationality of mainstream management practices. Our decision support framework might act as a vaccine for the so-called shiny object syndrome, the tendency to chase novel, popular, or exciting management practices without evaluating if they deliver what they promise.

Das Potenzial einer organisationalen Ambidextrie für die Bewältigung der digitalen Transformation bleibt in Gesundheitsorganisationen bisher weitgehend unerschlossen. Insbesondere die beidhändige Führung als die Fähigkeit von Führungskräften, sich flexibel auf Veränderungen einzustellen und die Kompetenzen der Mitarbeitenden auf verschiedenen Dimensionen immer wie der neu zu konfigurieren, um neues Wissen zu schaffen und neues Wissen in die Routine zu integrieren, wird in Gesundheitsorganisationen nicht genutzt. Ein dynamisches Ausbalancieren der gegensätzlichen Aktivitätsmuster einer beidhändigen Führung auf der Basis von Evidenzen unterschiedlicher Quellen stellt die Basis für die Gestaltung hochwertiger, innovativer Gesundheitsleistungen dar. In diesem Beitrag wird die Anwendung von in anderen Branchen bereits bewährten Ansätzen auf Gesundheitsleistungen und ihr potenzieller Beitrag für die Wissensgenerierung und für die Wissensintegration untersucht.

Portulacerebroside A (PCA), a cerebroside compound extracted from Portulaca oleracea L., has been shown to suppress hepatocellular carcinoma (HCC) cells. This study aims to investigate the effectiveness of trimethyl chitosan–cysteine (TMC-Cys) nanocarrier in delivering PCA for HCC management and to elucidate the molecular mechanisms behind PCA's function. TMC-Cys nanocarriers notably augmented PCA's function, diminishing the proliferation, migration, and invasiveness of HCC cells in vitro, reducing hepatocellular tumorigenesis in immunocompetent mice, and impeding metastasis of xenograft tumours in nude mice. Comprehensive bioinformatics analyses, incorporating Super-PRED systems alongside pathway enrichment analysis, pinpointed toll-like receptor 4 (TLR4) and epidermal growth factor receptor (EGFR) as two promising targets of PCA, enriched in immune checkpoint pathway. PCA/nanocarrier (PCA) reduced levels of TLR4 and EGFR and their downstream proteins, including programmed cell death ligand 1, thereby increasing populations and activity of T cells co-cultured with HCC cells in vitro or in primary HCC tumours in mice. However, these effects were counteracted by additional artificial activation of TLR4 and EGFR. In conclusion, this study provides novel evidence of PCA's function in immunomodulation in addition to its direct tumour suppressive effect. TMC-Cys nanocarriers significantly enhance PCA efficacy, indicating promising application as a drug delivery system. [ABSTRACT FROM AUTHOR]

From a longitudinal perspective, three successive directors of a Joint Master of Social Work program analyzed the process and strategies used in gaining Council on Social Work Education candidacy status and accreditation. Joint MSW programs are partnerships combining the resources of two or more universities to conduct one collaborative program. A literature review indicated that primary advantages for universities to create joint programs include innovative opportunity, social justice, the value of collaboration over competition, and cost savings for faculty lines. The process of building and negotiating a bi-university infrastructure, in addition to developing a new program, has many hidden complexities. Evidence-Based Management was a practical approach utilized during program development. The benefits and drawbacks of establishing a Joint MSW program are considered and can be used as a guide to determine if starting a joint program is warranted. Recommendations for how to establish a joint program are discussed along with the process of attaining accreditation. Key learnings during the process included developing fruitful collaborations, navigating value differences, understanding the importance of advocacy, assessing hidden costs, and managing necessary resource allocations. Given contemporary fiscal pressures within universities, it is important that joint programs develop a road map plan. [ABSTRACT FROM AUTHOR]

This clinical case report demonstrates the use of the Dahl Concept in the management of the repeated dislodgement of a posterior full coverage crown associated with a reduced restorative space. The described technique harnesses the addition of resin composite and a temporarily cemented provisional full coverage crown to create sufficient restorative space for the cementation of a definitive posterior full coverage crown restoration at the six-month review. [ABSTRACT FROM AUTHOR]

Introduction: There is growing interest in food prescriptions, which leverage health care settings to provide patients access to healthy foods through vouchers or food boxes. In this commentary, we draw on our experiences and interest in food prescribing to provide a summary of the current evidence on this intervention model and critically assess its limitations and opportunities. Rationale: Food insecurity is an important determinant of health and is associated with compromised dietary adequacy, higher rates of chronic diseases, and higher health service utilization and costs. Aligning with recent discourse on social prescribing and "food is medicine" approaches, food prescribing can empower health care providers to link patients with supports to improve food access and limit barriers to healthy diets. Food prescribing has been shown to improve fruit and vegetable intake and household food insecurity, although impacts on health outcomes are inconclusive. Research on food prescribing in the Canadian context is limited and there is a need to establish evidence of effectiveness and best practices. Conclusion: As food prescribing continues to gain traction in Canada, there is a need to assess the effectiveness, cost-efficiency, limitations and potential paternalism of this intervention model. Further, it is necessary to assess how food prescribing fits into broader social welfare systems that aim to address the underlying determinants of food insecurity. [ABSTRACT FROM AUTHOR]

This study investigates the scope, trends, and challenges of neurosurgical research in Nigeria since inception of the specialty in 1962. A bibliometric review of the neurosurgical literature from Nigeria was performed. Variables extracted included year and journal of publication, article topic, article type, research type, study design, article focus area, and limitations. Descriptive and quantitative analyses were performed for all variables. Trends of research publications were described in three periods: pioneering (1962–1981), recession (1982–2001), and resurgent (2002–2021). Of the 1023 included articles, 10.0% were published in the pioneering period, 9.2% in the recession period, and 80.8% in the resurgent period. Papers were predominantly published in World Neurosurgery (4.5%) and Nigerian Journal of Clinical Practice (4.0%). A total of 79.9% of the 4618 authors were from Nigerian institutions; 86.3% of the articles covered clinical research and were mainly focused on service delivery and epidemiology (89.9%). The most prominent topics were traumatic brain injury (25.8%) and central nervous system malignancy (21.4%). Only 4.4% of the publications received funding, mostly from agencies in the United States (31.7%). Barriers to neurosurgical research included lack of clinical databases (18.0%), increasing burden of disease (12.5%), and diagnostic challenges (12.4%). Neurosurgical research in Nigeria continues to grow due to increased training, workforce, and infrastructural improvements. Addressing the major challenges through establishment of research databases, development of evidence-based management guidelines, and increasing research training, funding and opportunities can increase research capacity in Nigeria. [ABSTRACT FROM AUTHOR]

Summary: Essential thrombocythaemia (ET) is a myeloproliferative neoplasm characterized by an increased risk of vascular complications and a tendency to progress to myelofibrosis and acute leukaemia. ET patients have traditionally been stratified into two thrombosis risk categories based on age older than 60 years and a history of thrombosis. More recently, the revised IPSET‐thrombosis scoring system, which accounts for the increased risk linked to the JAK2 mutation, has been incorporated into most expert recommendations. However, there is increasing evidence that the term ET encompasses different genomic entities, each with a distinct clinical course and prognosis. Moreover, the effectiveness and toxicity of cytoreductive and anti‐platelet treatments differ depending on the molecular genotype. While anti‐platelets and conventional cytoreductive agents, mainly hydroxycarbamide (hydroxyurea), anagrelide and pegylated interferon, remain the cornerstone of treatment, recent research has shed light on the effectiveness of novel therapies that may help improve outcomes. This comprehensive review focuses on the evolving landscape of treatment strategies in ET, with an emphasis on the role of molecular profiling in guiding therapeutic decisions. Besides evidence‐based management according to revised IPSET‐thrombosis stratification, we also provide specific observations for those patients with CALR‐, MPL‐mutated and triple‐negative ET, as well as cases with high‐risk mutations. [ABSTRACT FROM AUTHOR]

Introduction: Despite recent advances in diagnosis, prognostication, and treatment options, chronic lymphocytic leukemia (CLL) is still a largely incurable disease. New concepts on diagnosis, staging, treatment, and follow-up on CLL have been incorporated throughout recent years. The lack of regional consensus guidelines has led to varying practices in the management of patients with CLL in the region. This manuscript aims to reach a consensus among expert hematologists regarding the definitions, classifications, and related practices of CLL. The experts developed a set of statements utilizing their personal experience together with the current literature on CLL management. This consensus aims to provide guidance for healthcare professionals involved in the management of CLL and serves as a step in developing regional guidelines. Methods: Eight experts responded to 50 statements regarding the diagnosis, staging, treatment, and prognosis of CLL with three potential answering alternatives ranging between agree, disagree, and abstain. This consensus adopted a modified Delphi consensus methodology. A consensus was reached when at least 75% of the agreement to the answer was reached. This manuscript presents the scientific insights of the participating attendees, panel discussions, and the supporting literature review. Results: Of the 50 statements, a consensus was reached on almost all statements. Statements covered CLL-related topics, including diagnostic evaluation, staging, risk assessment, different patient profiles, prognostic evaluation, treatment decisions, therapy sequences, response evaluation, complications, and CLL during the COVID-19 pandemic. Conclusion: In recent years, CLL management has progressed significantly, with many diagnostic tests and several novel treatments becoming available. This consensus gathers decades of consolidated principles, novel research, and promising prospects for the management of this disease. [ABSTRACT FROM AUTHOR]

this review aims to explore key aspects related to the treatment of gingival recession defects (GRD) and sites lacking keratinized gingiva in orthodontic patients. It focuses on five crucial core aspects: 1) risk assessment for GRD development; 2) diagnosis, characteristics, and the dilemma surrounding GRD treatment necessity; 3) the evolution of root coverage procedures and the significance of modifying soft tissue phenotype for gingival margin stability; 4) the development and progression of gingival recessions in orthodontic patients; and 5) the staging of orthodontic and periodontal therapies; specifically, the consideration of preemptive soft tissue phenotype modification (STPM) or treatment of GRD. the management of GRD and sites lacking gingiva or with a thin mucosal phenotype, as well as the staging of periodontal and orthodontic treatment, should be guided by the positioning of the tooth within the alveolar bone envelope and the periodontal phenotype. In cases where the gingival phenotype is thin (< 1 mm), with or without GRD, it is advisable to perform preemptive soft tissue augmentation (PMT) prior to orthodontic treatment if the tooth is located within the alveolar bone envelope. Conversely, if the tooth is positioned outside the alveolar bone housing, orthodontic tooth movement should be employed to reposition the tooth within the bone housing before any soft tissue augmentation procedure is performed. Research has demonstrated a negative correlation between tooth position and periodontal root coverage, whereas tooth repositioning has shown a two-fold positive effect: 1) improving the surrounding soft tissues by reducing or eliminating the defect, and 2) enhancing the implementation and wound healing dynamics of root coverage procedures. [ABSTRACT FROM AUTHOR]

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Background and objectives: Without strategic actions in its support, the translation of scientific research evidence into health policy is often absent or delayed. This review systematically maps and assesses national-level strategic documents in the field of knowledge translation (KT) for health policy, and develops a practical template that can support Evidence-informed Policy Network (EVIPNet) Europe countries in producing national strategies for evidence-informed policy-making. Methods: Websites of organizations with strategic responsibilities in KT were electronically searched, on the basis of pre-defined criteria, in July–August 2017, and an updated search was carried out in April–June 2021. We included national strategies or elements of national strategies that dealt with KT activities, as well as similar strategies of individual institutions with a national policy focus. Two reviewers screened the strategies for inclusion. Data were analysed using qualitative content analysis. Results: A total of 65 unique documents were identified, of which 17 were eligible and analysed for their structure and content. Of the 17, 1 document was a national health KT action plan and 6 documents were institution-level KT strategies. The remaining 10 strategies, which were also included were 2 national health strategies, 5 national health research strategies and 3 national KT strategies (not specific to the field of health alone). In all, 13 structural elements and 7 major themes of health policy KT strategies were identified from the included documents. Conclusion: KT in health policy, as emerged from the national strategies that our mapping identified, is based on the production and accessibility of policy-relevant research, its packaging for policy-making and the activities related to knowledge exchange. KT strategies may play different roles in the complex and context-specific process of policy-making. Our findings show that the main ideas of health-specific evidence-informed policy literature appear in these strategies, but their effectiveness depends on the way stakeholders use them. Specific knowledge-brokering institutions and organizational capacity, advocacy about the use of evidence, and close collaboration and co-decision-making with key stakeholders are essential in furthering the policy uptake of research results. [ABSTRACT FROM AUTHOR]

Historically, osteoporosis has been viewed as a disease of women, with research, trials of interventions and guidelines predominantly focused as such. It is apparent, however, that this condition causes a substantial health burden in men also, and that its assessment and management must ultimately be addressed across both sexes. In this article, an international multidisciplinary working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases presents GRADE-assessed recommendations for the diagnosis, monitoring and treatment of osteoporosis in men. The recommendations are based on a comprehensive review of the latest research related to diagnostic and screening approaches for osteoporosis and its associated high fracture risk in men, covering disease burden, appropriate interpretation of bone densitometry (including the use of a female reference database for densitometric diagnosis in men) and absolute fracture risk, thresholds for treatment, and interventions that can be used therapeutically and their health economic evaluation. Future work should specifically address the efficacy of anti-osteoporosis medications, including denosumab and bone-forming therapies. In this Evidence-Based Guideline article, an international multidisciplinary working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases presents recommendations for the diagnosis, monitoring and treatment of osteoporosis in men. [ABSTRACT FROM AUTHOR]

The temporal variability of the thalamus in functional networks may provide valuable insights into the pathophysiology of schizophrenia. To address the complexity of the role of the thalamic nuclei in psychosis, we introduced micro‐co‐activation patterns (μCAPs) and employed this method on the human genetic model of schizophrenia 22q11.2 deletion syndrome (22q11.2DS). Participants underwent resting‐state functional MRI and a data‐driven iterative process resulting in the identification of six whole‐brain μCAPs with specific activity patterns within the thalamus. Unlike conventional methods, μCAPs extract dynamic spatial patterns that reveal partially overlapping and non‐mutually exclusive functional subparts. Thus, the μCAPs method detects finer foci of activity within the initial seed region, retaining valuable and clinically relevant temporal and spatial information. We found that a μCAP showing co‐activation of the mediodorsal thalamus with brain‐wide cortical regions was expressed significantly less frequently in patients with 22q11.2DS, and its occurrence negatively correlated with the severity of positive psychotic symptoms. Additionally, activity within the auditory–visual cortex and their respective geniculate nuclei was expressed in two different μCAPs. One of these auditory–visual μCAPs co‐activated with salience areas, while the other co‐activated with the default mode network (DMN). A significant shift of occurrence from the salience+visuo‐auditory‐thalamus to the DMN + visuo‐auditory‐thalamus μCAP was observed in patients with 22q11.2DS. Thus, our findings support existing research on the gatekeeping role of the thalamus for sensory information in the pathophysiology of psychosis and revisit the evidence of geniculate nuclei hyperconnectivity with the audio‐visual cortex in 22q11.2DS in the context of dynamic functional connectivity, seen here as the specific hyper‐occurrence of these circuits with the task‐negative brain networks. [ABSTRACT FROM AUTHOR]

Background: Screening for fetal alcohol spectrum disorder (FASD) has been identified as a promising approach to improve recognition, understanding and effective response to the unique needs of those with FASD in criminal legal settings. However, to date, there has been limited synthesis of relevant screening tools, indicators, or implementation considerations in this context. Aims: The present review aimed to synthesise evidence and develop a conceptual framework for understanding how, when, why, for whom and by whom FASD screening tools, items and/or indicators and characteristics serve to accurately identify people with FASD in criminal legal contexts, with consideration of individual and system needs relevant to effective implementation and response. Methods: A preregistered search was conducted using a modified realist review framework for both peer‐reviewed articles and grey literature. Included sources were available in English, which focused on individuals with prenatal alcohol exposure and/or FASD with criminal legal involvement and offered new empirical evidence. Sources were reviewed using the Quality Control Tool for Screening Titles and Abstracts by Second Reviewer framework, extracted using a structured coding form and narratively synthesised. Results: The search yielded 52 sources, 11 FASD screening tools designed for or applied in criminal legal settings and 38 potential FASD indicators or characteristics relevant to identifying people who may have FASD in criminal legal settings, organised into six conceptually related domains. There was limited evidence supporting the psychometric properties of screening tools across populations or settings, though growing evidence highlights the promise of some instruments. Although few studies characterised potential considerations to be made when implementing a screening tool or approach, both system and individual level needs related to recognising and effectively responding to FASD in criminal legal contexts were identified, and findings revealed strong support among legal and clinical professionals regarding the need for FASD screening in these settings. Conclusions: Findings of this review can be used to inform the development, selection, implementation and evaluation of FASD screening tools in criminal legal settings and underscore a continued need for enhanced resources, policy and cross‐sectoral response to better support the needs of people with FASD in the criminal legal contexts. [ABSTRACT FROM AUTHOR]

Ecotourism management can draw on theory and data related to non‐consumptive effects of risk on wildlife. The asset protection principle (APP) predicts that variable food supply and its associated risks will affect antipredator behavior; responses to predation risk should dominate when food reserves are high, while nutritional risk becomes more important when food reserves are limited. Additionally, the human shield hypothesis (HSH) describes how some individuals might seek human presence if it repels potential sources of risk. Using camera traps, we used generalized linear mixed effects and multinomial regression models to test components of the APP and HSH where ecotourism co‐occurs with grizzly bear (Ursus arctos) foraging during hyperphagia. When salmon abundance was high (+1 SD), bear activity (weekly detections) decreased by 13% with every 100 visitors/week. Under low salmon conditions, bear activity increased with visitor numbers, creating 'high bear‐high visitor' conditions. Consistent with HSH, detection data revealed an increased likelihood of detecting subordinate age‐sex classes compared with adult males when visitor numbers were high. Our findings suggest that when salmon are low, managers might consider limiting visitors to mitigate disturbance. More broadly, understanding how wildlife allocate anti‐predator behavior as a function of risk and food can inform conservation science and practice. [ABSTRACT FROM AUTHOR]

Background: The success of abdominal cancer surgery depends not only on the surgery itself but is influenced by the overall perioperative management. Given the multitude of perioperative measures and the ever-increasing number of studies on perioperative management, it is difficult to keep track and provide evidence-based perioperative management. The planned guideline on perioperative management will review the existing evidence and derive treatment recommendations. Methods: The processing of the evidence is carried out by 6 working groups according to an 8-step scheme: after drafting the guideline questions in PICO format (1), a systematic literature search is carried out (2), and the records found are screened by two independent reviewers from the coordination team. Subsequently, the full texts of the potentially relevant articles are made available to the working groups for full text screening (3). All articles to be included are reviewed for methodological quality (4) before summary of findings tables are generated (5). In line with the GRADE approach, confidence in the evidence is assessed (6) before a recommendation is derived from the evidence, using a modified GRADE Evidence to Decision Framework (7). Finally, all recommendations are compiled and agreed within the guideline group (8). Discussion: Guidelines serve as foundation for therapy decisions in everyday clinical practice and should therefore be based on up-to-date research results. However, while primary studies and systematic reviews are critically reviewed for their methodological quality, the process of guideline development is often not comprehensible. A protocol with predefined methodology should therefore create transparency and strengthen confidence in the recommendations. Trial registration: The guideline is registered in the AWMF (Association of the Scientific Medical Societies) Guideline Register (088—010OL). [ABSTRACT FROM AUTHOR]

• There is an association between maternal and fetal Doppler in early labour with the occurrence of labour complications. • A predictive model including early labour CPR and mean UtA Doppler allows the identification of over three out of four women at low-risk of intrapartum hypoxia that are submitted to obstetric intervention due to suspected intrapartum fetal compromise. • The predictive model has a good capacity to rule out and a moderate capacity to rule in OI due to IFC, albeit with poor predictive value. • The predictive model including antenatal and intrapartum characteristics combined with abnormal CPR and mean UtA PI may be used as a screening tool for subclinical uteroplacental insufficiency manifesting during active labor. The evidence-based management of human labor includes the antepartum identification of patients at risk for intrapartum hypoxia. However, available evidence has shown that most of the hypoxic-related complications occur among pregnancies classified at low-risk for intrapartum hypoxia, thus suggesting that the current strategy to identify the pregnancies at risk for intrapartum fetal hypoxia has limited accuracy. To evaluate the role of the combined assessment of the cerebroplacental ratio (CPR) and uterine arteries (UtA) Doppler in the prediction of obstetric intervention (OI) for suspected intrapartum fetal compromise (IFC) within a cohort of low-risk singleton term pregnancies in early labor. Prospective multicentre observational study conducted across four tertiary Maternity Units between January 2016 and September 2019. Low-risk term pregnancies with spontaneous onset of labor were included. A two-step multivariable model was developed to assess the risk of OI for suspected IFC. The baseline model included antenatal and intrapartum characteristics, while the combined model included antenatal and intrapartum characteristics plus Doppler anomalies such as CPR MoM < 10th percentile and mean UtA Doppler PI MoM ≥ 95th percentile. Predictive performance was determined by receiver–operating characteristics curve analysis. 804 women were included. At logistic regression analysis, CPR MoM < 10th percentile (aOR 1.269, 95 % CI 1.188–1.356, P < 0.001), mean UtA PI MoM ≥ 95th percentile (aOR 1.012, 95 % CI 1.001–1.022, P = 0.04) were independently associated with OI for suspected IFC. At ROC curve analysis, the combined model including antenatal characteristics plus abnormal CPR and mean UtA PI yielded an AUC of 0.78, 95 %CI(0.71–0.85), p < 0.001, which was significantly higher than the baseline model (AUC 0.61, 95 %CI(0.54–0.69), p = 0.007) (p < 0.001). The combined model was associated with a 0.78 (95 % CI 0.67–0.89) sensitivity, 0.68 (95 % CI 0.65–0.72) specificity, 0.15 (95 % CI 0.11–0.19) PPV, and 0.98 (0.96–0.99) NPV, 2.48 (95 % CI 2.07–2.97) LR + and 0.32 (95 % CI 0.19–0.53) LR- for OI due to suspected IFC. A predictive model including antenatal and intrapartum characteristics combined with abnormal CPR and mean UtA PI has a good capacity to rule out and a moderate capacity to rule in OI due to IFC, albeit with poor predictive value. [ABSTRACT FROM AUTHOR]

Enterprises employ information systems to carry out their day-to-day business operations. Organizations implement business policies to enhance their competitive edge through efficient process management. This paper aims to propose a method that combines two approaches: evidencebased policymaking and process mining, to facilitate process reengineering. While numerous evidence-based approaches utilizing process mining techniques have been employed to assess process performance through measurements, these methods often focus on individual process instances. This is in contrast to Business Process Redesign (BPR) assessments, which encompass more comprehensive performance measurements, including overall process performance. This study proposes a method for analyzing process execution time, which includes Cycle time, Lead time, and Activity time. The aim is to support evidence-based policymaking in information systems through the use of process mining. Several key performance indicators (KPIs) have been defined for evidence-based management of business processes to identify process bottlenecks. The results of this paper demonstrate the application of process mining in analyzing the execution time of business processes. Using a real-world dataset, the study identified time-consuming activities and provided key performance indicators (KPIs) to guide process optimization. These findings demonstrate the effectiveness of process mining in identifying bottlenecks and inefficiencies within operational processes, ultimately leading to improved process performance and efficiency [ABSTRACT FROM AUTHOR]

Objectives: In an era of management hype, where management concepts quickly become buzzwords within the business community (e.g., chat GPT, Artificial Intelligence, pay transparency or Industry 5.0), the crucial skill of a manager is the ability to think critically about the rationality of all those fashionable management practices. To stimulate this, we present a heuristic decision support framework to assist managers in thinking more critically about management fashions – management practices that are intensively promoted and attract public attention but might merely imitate rationality and progress. Material and methods: We employ a method of conceptual analysis, drawing from Abrahamson’s management fashion theory, self-determination theory, literature on management fads and evidence-based management. Results: The proposed decision-making support framework presents a heuristic decision tree based on three steps to evaluate management practices’ rationality, involving critical thinking about their goals, importance, and efficiency. Conclusions: The framework can be used not only to assist managerial decision-making but also to teach management students to think more critically and to empower the business community to question the rationality of currently fashionable management practices. Our decision support framework might act as a vaccine for the so-called shiny object syndrome, the tendency to chase novel, popular, or exciting management practices without evaluating if they deliver what they promise. [ABSTRACT FROM AUTHOR]

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The hilsa (Tenualosa ilisha) fishery in Myanmar is of importance as it provides an income for around 1.6 million artisanal low-income fisher households and generated USD 237.32M in export earnings from 156,000 metric tons in 2021. Fisheries Performance Indicator assessments have shown that the fishery, both artisanal and industrial, is close to economic collapse. Research was undertaken to find ways to improve the management of the fishery including studies to establish the migration routes and spawning periodicity of hilsa in addition to socioeconomic assessments and business case valuations to recommend finance mechanisms for improved management and maintenance of the fishery. Results indicate that the closed season for hilsa fishing misses the main spawning period in September. In addition, the chemical analysis of hilsa otoliths shows the importance of upstream spawning grounds - some 800km from the sea. Recommendations were made, and enacted March 2022, regarding the need for a new September closed season in addition to no-take hilsa sanctuaries along the main migration routes. A value was placed on the hilsa fishery at close to USD800M per annum. A USD100M annual investment cost is suggested to ensure that the new and old closed seasons are respected by licensed and unlicensed fishers. This investment could be generated by recommended fiscal reforms to provide incentives for fishers to respect the new fishing restrictions. Transboundary fisheries management opportunities are being advanced by informal tripartite scientific collaboration between Bangladesh, India and Myanmar. Social aspects, involving fisheries co-management with artisanal fisher communities and local government authorities, need to be continued to demonstrate the benefits of improved fisheries management in terms of the expected sustainable yields and a move away from potential economic fishery collapse. [ABSTRACT FROM AUTHOR]

Actinic keratosis is a common skin condition that has the potential to develop into malignant neoplastic lesions. Factors that are known to increase the likelihood of developing actinic keratosis include older age, male gender, UV exposure, and immunosuppressive treatment. Understanding the pathogenesis and significance of actinic keratosis as an initial form of the neoplastic process associated with a sequence of lesions arising on photodamaged skin has led to the concept of field cancerization. The choice of the optimal therapeutic pathway depends on the number of actinic keratosis lesions and the degree of photodamage in the skin, as well as the advancement of skin lesions. The clinical presentation of skin lesions also allows monitoring of the patient's condition over time and assessing response to treatment, and facilitates rational decisions regarding potential therapy adjustments. This article outlines the guidelines for the diagnosis and treatment of actinic keratosis in Poland and presents an evidence-based management regimen that incorporates the practical clinical experience of dermatology experts. The recommendations cover a range of topics including topical treatment options, cryosurgery, photodynamic therapy with a photosensitizing agent, and combination treatments. [ABSTRACT FROM AUTHOR]

Advances in classroom behavior management mobile applications (CBM apps) have led some teachers to use them to supplement their existing student management strategies, although little is known about their effectiveness in facilitating behavior change. This systematic review aimed to identify and appraise research on the effectiveness of CBM apps for promoting positive behavioral and learning outcomes of elementary, middle, and high school students. A systematic search was conducted in the PsycINFO, ERIC, and EBSCOhost databases for articles published between 2007 and 2020. The 15 included studies provided some preliminary evidence for CBM apps. Apps were primarily used to facilitate the delivery of self-monitoring interventions (SCORE IT and I-Connect) or class-wide reinforcement systems (ClassDojo and the Classroom Behavior Management System). An evaluation of study quality using the What Works Clearinghouse design standards (version 5.0) yielded mixed results, with only 53% of the included studies meeting standards with or without reservations. In general, these studies showed limited risk of bias and moderate to strong effect sizes. Based on the findings of the review, we provide practice recommendations and describe areas for future research. [ABSTRACT FROM AUTHOR]

This article is an English translation of the Clinical Practice Guidelines for Upper Tract Urothelial Carcinoma (2nd edition) published in June 2023. The Japanese Urological Association's (JUA) Guidelines Committee on Upper Tract Urothelial Carcinoma (UTUC) created a 2023 update guideline to support clinicians' current evidence‐based management of UTUC and to incorporate its recommendations into clinical practice. The new guideline adhered as closely as possible to the Minds Manual for Guideline Development 2020 ver. 3.0. Findings related to epidemiological, pathological, diagnosis, treatment, and follow‐up were reviewed. In addition, seven clinical questions (CQs) were set to determine the grade of recommendation and level of evidence. Preconceptions and biases were removed from the preparation process, the overall evidence was evaluated appropriately, and recommendations were made after fully considering the balance between benefits and harms. Although the evidence is still insufficient to be taken up as a CQ, the latest important information is described in seven columns, and clinical issues that should be resolved in the future related to the CQ are described as recommendations for tomorrow. We hope that these guidelines will help medical professionals, patients, and their families involved in the treatment of UTUC in their decision‐making, and hope that a critical review of these guidelines will lead to further refinements in the next edition. [ABSTRACT FROM AUTHOR]

The turkeys are reared throughout the national territory of Benin, but their breeding is less developed than other poultry species, such as chickens and ducks. The current study aimed to characterize turkey farming in Southern Benin to identify the constraints associated with the farming practice that limit its development. A survey was performed in 104 turkey farms in the Atlantic, Ouémé, and Zou departments. The frequencies of qualitative variables and average quantitative variables were calculated and compared across departments. The investigated variables included turkey housing, feeding practices, reproduction management, health management, difficulties encountered, marketing of animals, and farm products. It was found that the housing, feeding, health monitoring, and constraints varied from one department to another. The turkeys were raised in fence-run buildings in the Ouémé (76.7%), modern poultry houses in the Atlantic (75%), and traditional habitats (42.9%) with a free range in the Zou. The free range prevented farmers from separating the turkeys from other poultry species. The poultry species present with turkeys on studied farms were chickens, ducks, and guinea fowl. The turkeys were fed more with commercial feed in the Atlantic (100%) and Ouémé (92.7%) regions and with cereals and agricultural by-products in Zou (82.1%). The prophylaxis consisted of deworming the birds, vaccinating them against Newcastle disease, controlling bacterial infections with antibiotics, and giving them vitamins in drinking water. The farmers vaccinated more turkeys in Zou than in Atlantic and Ouémé. The vaccination and administration of antibiotics do not prevent the introduction of disease into farms due to poor farm biosecurity, resulting in animal deaths. In conclusion, this study identified the obstacles that limit the development of turkey farming by region in Southern Benin. These barriers are primarily related to housing, feeding, mating, and marketing. Scientific research could potentially solve some of these issues, notably those concerning feeding and mating success. However, housing and marketing concerns would necessitate support from the authorities. [ABSTRACT FROM AUTHOR]

Purpose: Policy-making based on research evidence is a management approach that is based on moving from the completely intuitive and unconscious spectrum to the scientific spectrum and considering all organizational capacities. Most of this scientific evidence has been obtained through academic institutions and research centers. Many countries of the world establish many scientific institutions and associations and employ a wide range of researchers to analyze and evaluate the results of academic research to align their decisions and programs with the latest research and scientific findings. Therefore, this research aimed to examine how to link the decisions and policies of the National Library and Archive of Iran (NLAI) with scientific and research evidence, to identify possible obstacles and solutions to overcome them. Method: The current survey was conducted with an analytical approach. The main tool for data collection was a semi-structured interview designed via a questionnaire with open and closed questions. The research community and sample size were purposefully selected from among the employees of NLAI so that they have at least 15 years of work experience and a master's degree or higher. 164 people agreed and answered the questions. To measure validity, the questionnaire was provided to 5 librarians and experts in the field of evidence-based policy and management. To measure the reliability, 35 questionnaires were distributed and collected among the studied population, and then the reliability of the questionnaire was measured using Cronbach's alpha test. Kolmogorov-Smirnov (k-s), univariate t, and Friedman tests were used in the analyses. Findings: The employees believed that the use of data and research findings for decision-making and planning in specialized departments of the organization is necessary (4.25 on a scale of 5). To solve the work problems, they have faced so far, many employees (4 out of 5) have found the need to use scientific data and research evidence can improve their efficiency in performing specialized activities. On the other hand, they believed that scientific and research evidence is used less than average for decisions and planning at the macro-organizational level. Conclusion: NLAI planners and managers who want to avoid failure in decisions and programs should pay more attention to the use of scientific and research evidence. In this way, they can improve their knowledge and awareness of the consequences of uncertainty and risk reduction in the work field. [ABSTRACT FROM AUTHOR]

Background: Screening, brief intervention, and referral (SBIR) is an evidence-based, comprehensive health promotion approach commonly implemented to reduce alcohol and substance use. Implementation research on SBIR demonstrate that patients find it acceptable, reduces hospital costs, and it is effective. However, SBIR implementation in hospital settings for multiple risk factors (fruit and vegetable consumption, physical activity, alcohol and tobacco use) is still emergent. More evidence is needed to guide SBIR implementation for multiple risk factors in hospital settings. Objective: To explore the facilitators and barriers of SBIR implementation in a rural hospital using the Consolidated Framework for Implementation Research (CFIR). Methods: We conducted a descriptive qualitative investigation consisting of both inductive and deductive analyses. We conducted virtual, semi-structured interviews, guided by the CFIR framework. All interviews were audio-recorded, and transcribed verbatim. NVivo 12 Pro was used to organize and code the raw data. Results: A total of six key informant semi-structured interviews, ranging from 45 to 60 min, were carried out with members of the implementation support team and clinical implementers. Implementation support members reported that collaborating with health departments facilitated SBIR implementation by helping (a) align health promotion risk factors with existing guidelines; (b) develop training and educational resources for clinicians and patients; and (c) foster leadership buy-in. Conversely, clinical implementers reported several barriers to SBIR implementation including, increased and disrupted workflow due to SBIR-related documentation, a lack of knowledge on patients' readiness and motivation to change, as well as perceived patient stigma in relation to SBIR risk factors. Conclusion: The CFIR provided a comprehensive framework to gauge facilitators and barriers relating to SBIR implementation. Our pilot investigation revealed that future SBIR implementation must address organizational, clinical implementer, and patient readiness to implement SBIR at all phases of the implementation process in a hospital. [ABSTRACT FROM AUTHOR]

Background: The management of low back pain (LBP) is highly variable and patients often receive management that is not recommended and/or miss out on recommended care. Clinician knowledge and behaviours are strongly influenced by entry-level clinical training and are commonly cited as barriers to implementing evidence-based management. Currently there are no internationally recognised curriculum standards for the teaching of LBP content to ensure graduating clinicians have the appropriate knowledge and competencies to assess and manage LBP. We formed an international interdisciplinary working group to develop curriculum content standards for the teaching of LBP in entry-level clinical training programs. Methods: The working group included representatives from 11 countries: 18 academics and clinicians from healthcare professions who deal with the management of LBP (medicine, physiotherapy, chiropractic, osteopathy, pharmacology, and psychology), seven professional organisation representatives (medicine, physiotherapy, chiropractic, spine societies), and one healthcare consumer. A literature review was performed, including database and hand searches of guidelines and accreditation, curricula, and other policy documents, to identify gaps in current LBP teaching and recommended entry-level knowledge and competencies. The steering group (authors) drafted the initial LBP Curriculum Content Standards (LBP-CCS), which were discussed and modified through two review rounds with the working group. Results: Sixty-two documents informed the draft standards. The final LBP-CCS consisted of four broad topics covering the epidemiology, biopsychosocial contributors, assessment, and management of LBP. For each topic, key knowledge and competencies to be achieved by the end of entry-level clinical training were described. Conclusion: We have developed the LBP-CCS in consultation with an interdisciplinary, international working group. These standards can be used to inform or benchmark the content of curricula related to LBP in new or existing entry-level clinical training programs. [ABSTRACT FROM AUTHOR]

Background: Evidence-based interventions (EBIs) are frequently modified in practice. It is recommended that decisions to modify EBIs should be made deliberately to ensure fidelity-consistency, yet the relationship between fidelity-consistency and deliberateness is not well understood. This study aims to explore modifications in a sample of practitioners delivering evidence-based parenting programs (i.e., interventions to strengthen parent–child relationships, reduce harmful interactions, and improve child health and well-being). The study investigated three research questions: (1) What kind of modifications are made during the delivery of parenting programs? (2) To what degree are the identified modifications consistent with the core functions of each program? and (3) Is deliberateness associated with the fidelity-consistency of the identified modifications? Methods: In total, 28 group leaders of five widely disseminated parenting programs in Sweden participated in five focus groups, and two participants from each group also participated in individual interviews (n = 10). A content analysis approach was used where the identification of modifications was directed by the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) and then assessed for fidelity-consistency and four levels of deliberateness (universal, situational, conditional, and unintentional). Chi-square tests were performed to compare consistent and inconsistent modifications, and logistic regression was performed to explore whether deliberateness predicted consistency. Results: A total of 137 content modifications were identified, covering most of the content modification categories in FRAME. The most common were tailoring/tweaking/refining, adding elements, shortening/condensing, lengthening/extending, and integrating another treatment. Modifications were mostly fidelity-consistent but consistency varied greatly among categories. Furthermore, modifications made unintentionally or situationally were more likely to be fidelity-inconsistent. Conclusions: These results indicate that explicit consideration of modifications and their impact could be essential for sustaining the fidelity-consistent use of EBIs, even as such interventions are continuously modified. [ABSTRACT FROM AUTHOR]

Evidence-based management (EBM) is an increasingly advocated yet rarely adopted framework to assist in making organizational decisions. We investigate how cognitive reflection – the ability or disposition to question an intuitive response and rely instead on a more analytical process—influences decision-making accuracy in the context of EBM. Across three experimental studies (N = 332, 166 and 99), we determine the effects of using actively sought and passively sought evidence, in boundary conditions of cognitive and emotional load. Results of study 1 show that cognitive reflection is generally associated with higher decision-making accuracy, particularly in passive pathways to EBM, and when exposed to low cognitive load. Results of studies 2 and 3 support that passive pathways to EBM will result in higher accuracy, and that negative emotion inducing stimuli can strengthen the effect of cognitive reflection on evidence collection. The findings demonstrate that a contingency approach to EBM is critical, with the impact of cognitive reflection differing for situational constraints and for actively and passively sought evidence. [ABSTRACT FROM AUTHOR]

Aim: The primary aim of the European Society of Coloproctology (ESCP) Guideline Development Group (GDG) was to produce high‐quality, evidence‐based guidelines for the management of cryptoglandular anal fistula with input from a multidisciplinary group and using transparent, reproducible methodology. Methods: Previously published methodology in guideline development by the ESCP has been replicated in this project. The guideline development process followed the requirements of the AGREE‐S tool kit. Six phases can be identified in the methodology. Phase one sets the scope of the guideline, which addresses the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula in adult patients presenting to secondary care. The target population for this guideline are healthcare practitioners in secondary care and patients interested in understanding the clinical evidence available for various surgical interventions for anal fistula. Phase two involved formulation of the GDG. The GDG consisted of 21 coloproctologists, three research fellows, a radiologist and a methodologist. Stakeholders were chosen for their clinical and academic involvement in the management of anal fistula as well as being representative of the geographical variation among the ESCP membership. Five patients were recruited from patient groups to review the draft guideline. These patients attended two virtual meetings to discuss the evidence and suggest amendments. In phase three, patient/population, intervention, comparison and outcomes questions were formulated by the GDG. The GDG ratified 250 questions and chose 45 for inclusion in the guideline. In phase four, critical and important outcomes were confirmed for inclusion. Important outcomes were pain and wound healing. Critical outcomes were fistula healing, fistula recurrence and incontinence. These outcomes formed part of the inclusion criteria for the literature search. In phase five, a literature search was performed of MEDLINE (Ovid), PubMed, Embase (Ovid) and the Cochrane Database of Systematic Reviews by eight teams of the GDG. Data were extracted and submitted for review by the GDG in a draft guideline. The most recent systematic reviews were prioritized for inclusion. Studies published since the most recent systematic review were included in our analysis by conducting a new meta‐analysis using Review manager. In phase six, recommendations were formulated, using grading of recommendations, assessment, development, and evaluations, in three virtual meetings of the GDG. Results: In seven sections covering the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula, there are 42 recommendations. Conclusion: This is an up‐to‐date international guideline on the management of cryptoglandular anal fistula using methodology prescribed by the AGREE enterprise. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases. The effect of probiotic administration on the severity of AD in adults has shown inconsistent results. Objectives: To determine the effectiveness of probiotic supplementation as a therapeutic tool for adult AD. Methods: PubMed, Scopus and Embase were systematically searched to collect data from studies in which probiotics were administered to treat adult AD. Results: Out of 413 publications, 9 papers were included in the meta-analysis. Significant differences in the ScORing Atopic Dermatitis tool favouring probiotics were observed [relative risk (RR) –5.93, 95% confidence interval (CI) –8.43 to –3.43]. Lactobacillus salivarius presented with largest effect size (RR –9.79, 95% CI –13.04 to –6.54), followed by L. acidophilus (RR –5.77, 95% CI –10.82 to –0.72) and L. plantarum (RR –3.76, 95% CI –6.36 to –1.16). No benefit was observed with L. fermentum. Based on the severity of AD, probiotics showed better results in people with moderate-to-severe AD (RR –9.12, 95% CI –12.17 to –6.08) than in individuals with mild disease (RR –2.67, 95% CI –4.67 to –0.66). Serum levels of IgE and eosinophil count remained significantly unchanged after the probiotic intervention (RR 0.25, 95% CI –0.10 to 0.60; RR –0.27, 95% CI –0.68 to 0.13, respectively). Conclusions: Current evidence supports a role for some probiotics as a therapeutic tool for the treatment of adult AD, particularly in patients with severe AD. The efficacy of probiotics is strain specific, with L. salivarius and L. acidophilus having the largest clinical benefit. Such benefit is apparently independent of IgE levels and eosinophil count. Despite these encouraging results, the decrease in AD severity did not translate into a clinically meaningful better quality of life as assessed by the Dermatology Life Quality Index. There currently is not enough reliable data to reach conclusions about the optimal dose and duration for probiotic treatment. Our meta-analysis supports the role of some probiotics as a therapeutic tool for the treatment of adult atopic dermatitis (AD), particularly in those with severe AD. Efficacy of probiotics is strain specific, and Lactobacillus salivarius and L. acidophilus confer the largest clinical benefit. This benefit is apparently independent of IgE levels and eosinophil count. Despite these encouraging results, the decrease in AD severity did not seem to translate into a better quality of life as assessed by the Dermatology Life Quality Index. [ABSTRACT FROM AUTHOR]

The incidence of breast cancer is increasing rapidly in urban India due to the changing lifestyle and exposure to risk factors. Diagnosis at an advanced stage and in younger women are the most concerning issues of breast cancer in India. Lack of awareness and social taboos related to cancer diagnosis make women feel hesitant to seek timely medical advice. As almost half of women develop breast cancer at an age younger than 50 years, breast cancer diagnosis poses a huge financial burden on the household and impacts the entire family. Moreover, inaccessibility, unaffordability, and high out-of-pocket expenditure make this situation grimmer. Women find it difficult to get quality cancer care closer to their homes and end up traveling long distances for seeking treatment. Significant differences in the cancer epidemiology compared to the west make the adoption of western breast cancer management guidelines challenging for Indian women. In this article, we intend to provide a comprehensive review of the management of breast cancer from diagnosis to treatment for both early and advanced stages from the perspective of low-middle-income countries. Starting with a brief introduction to epidemiology and guidelines for diagnostic modalities (imaging and pathology), treatment has been discussed for early breast cancer (EBC), locally advanced, and MBC. In-depth information on loco-regional and systemic therapy has been provided focusing on standard treatment protocols as well as scenarios where treatment can be de-escalated or escalated. [ABSTRACT FROM AUTHOR]

This review article examines the evidence-based management of colorectal cancers, focusing on topics characterized by ongoing debates and evolving evidence. To contribute to the scientific discourse, we intentionally exclude subjects with established guidelines, concentrating instead on areas where the current understanding is dynamic. Our analysis encompasses a thorough exploration of critical themes, including the evidence surrounding complete mesocolic excision and D3 lymphadenectomy in colon cancers. Additionally, we delve into the evolving landscape of perioperative chemotherapy in both colon and rectal cancers, considering its nuanced role in the context of contemporary treatment strategies. Advancements in surgical techniques are a pivotal aspect of our discussion, with an emphasis on the utilization of minimally invasive approaches such as laparoscopy and robotic surgery in both colon and rectal cancers, including advanced rectal cases. Moving beyond conventional radical procedures, we scrutinize the feasibility and implications of endoscopic resections for small tumors, explore the paradigm of organ preservation in locally advanced rectal cancers, and assess the utility of total neoadjuvant therapy in the current treatment landscape. Our final segment reviews pivotal trials that have significantly influenced the management of colorectal liver and peritoneal metastasis. [ABSTRACT FROM AUTHOR]

Background: Police officers are frequently exposed to a wide variety of potentially traumatic events (PTE) and are therefore at a considerable risk of developing posttraumatic stress disorder (PTSD). Previous research estimated the point prevalence of PTSD in Belgian police officers at 7.4%, significantly higher than in the general population. An effective organisational strategy to manage posttraumatic stress is essential. Objective: We aimed to develop a novel organisational approach regarding traumatic stress for Belgian police, combining evidence-based strategies for the prevention and treatment of posttraumatic stress in a stepped care intervention model. Method: In a broad development process, we combined scientific literature, case studies of best practices from other police organisations with insights gathered from a number of expert panels, thematic working groups and feedback groups. Results: A comprehensive stepped care intervention model was developed, consisting of evidence-based interventions for the prevention and treatment of posttraumatic stress. Conclusions: The intervention model is a promising organisational strategy for the management of posttraumatic stress in police organisations based on evidence-based interventions. Its effectiveness will be studied in the coming years. [ABSTRACT FROM AUTHOR]

Foot disease is a devastating complication of diabetes. For almost 3 decades, the mission of the International Working Group on the Diabetic Foot (IWGDF) is to produce evidence-based guidelines to inform health care providers worldwide on strategies for the prevention and management of diabetes-related foot disease. In this publication, we aim to better inform the reader about 'the story behind' the IWGDF Guidelines and thus facilitate improved uptake of the recommendations described in the guidelines. The first IWGDF Guidelines were published in 1999, and these have been successfully updated every 4 years since. With each update, IWGDF has improved the methodological rigour and extended the topics covered. This has been possible thanks to the involvement of > 100 experts from > 60 countries, all voluntarily dedicating their time. We estimate that the 2023 update of the IWGDF Guidelines required a total 10 years of full-time work, which would have cost 2 million euros if the voluntary work had been financially compensated. The IWGDF Guidelines are not only published in English but also translated to support local implementation. Currently available translations serve 2.9 billion people globally in their native language. As an independent and multidisciplinary organisation, IWGDF hopes that the 2023 update will continue to stimulate clinicians from all different disciplines to deliver the best care possible for these patients, will motivate researchers to undertake the high-quality trials needed to deliver the new evidence to advance the field further, and collectively will support people with diabetes-related foot disease to minimize their disease burdens. [ABSTRACT FROM AUTHOR]

The genetic progress achieved by animal breeding programs may be affected by genotype-by-climate interactions (GxC). This systematic literature review assesses the scientific evidence for GxC on multiple traits of cattle, pigs, and poultry. Two search engines (Scopus, Web of Science) were queried for original peer-reviewed scientific (English full-text) studies. We included (1) observational studies and designed experiments considering dairy or beef cattle, swine, chicken or turkeys, where (2) at least one production, fertility, or health trait was tested for GxC, (3) the existence of GxC was tested directly based on temperature, relative humidity, or climatic indices for heat or cold stress, and (4) genetic effects within a breed or line were investigated. The search resulted in 46 eligible studies, with a (low) risk that the requirement of full-text English studies may have resulted in some work not included in this review. Our review shows an increase in GxC studies from 2015 onwards. Cattle was the most studied species (n = 36; 78.3%), whereas eligible studies on turkeys were lacking. Climatic parameters used in the studies ranged from well-known parameters (e.g., temperature, temperature-humidity index) to more complex indices combining temperature, relative humidity, wind speed and solar radiation. All observational studies (n = 40; 87.0%) used weather station data. In total, 75 traits were studied, which were predominantly production traits regardless of species. Studies on fertility and health traits have been emerging from 2010 onwards, but their numbers still lag far behind those for production traits. Genotype-by-climate interaction was confirmed in 54.0% of the study outcomes. This systematic review shows that little is known about the role of GxC in health and fertility traits in cattle, and for all traits in pigs and poultry in general. As current evidence shows that genotype-by-climate interaction is common across species and traits, we suggest to collect detailed climatic data and use them to assess the presence of GxC in indoor and outdoor production systems, as well. [ABSTRACT FROM AUTHOR]

The symptom of dry mouth has multiple potential etiologies and can be a diagnostic clue to the presence of common systemic diseases encountered in rheumatology practice. The presence of decreased saliva flow (i.e. salivary hypofunction) defines a subset of dry mouth patients in whom there may be reversible drug effects, an iatrogenic insult such as head and neck irradiation, or a disease that directly involves the salivary glands (e.g. Sjögren's disease). The assessment of salivary hypofunction includes sialometry, salivary gland imaging, salivary gland biopsy, and an assessment for relevant systemic diseases. Optimal management of dry mouth requires accurate definition of its cause, followed by general measures that serve to alleviate its symptoms and prevent its complications. Through a literature search on xerostomia and salivary hypofunction, we provide an overview of the causes of dry mouth, highlight the potential impact of salivary hypofunction on oral and systemic health, detail routine evaluation methods and treatment strategies, and emphasize the importance of collaboration with oral health care providers. Our Expert Opinion is provided on unmet needs in the management of dry mouth and relevant research progress in the field. [ABSTRACT FROM AUTHOR]

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